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PAEDIATRICS > Fever & Vomiting > Flashcards

Fever & Vomiting Flashcards

1
Q

Define fever of unknown origin

A

Daily temperatures >38c for at least 8-14 days with no diagnosis

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2
Q

Mechanisms that cause fever x3

A

Pyrogens
Heat production exceeding loss
Defective heat loss

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3
Q

Role of endotoxin in fever x2

A

Stimulate endogenous pyrogens
Directly affect thermoregulation in the hypothalamus

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4
Q

Role of hypothalamus in temperature regulation x6

A

Generates physiologic changes like shivering and vasoconstriction to increase core temperature
To reduce- sweating, vasodilation, sensation of feeling hot

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5
Q

2 causes of defective heat loss

A

Ectodermal dysplasia
Victims of severe heat exposure

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6
Q

State 5 autonomic changes associated with nausea

A

Salivation
Cold sweating
Peripheral vasoconstriction
Proximal gastric relaxation
Retrograde movement of intestinal contents

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7
Q

Events accompanying retching x4

A
  1. Spasmodic contraction of diaphragm and abdominal wall
  2. Closing of the glottis
  3. Relaxation of the lower esophageal sphincter
  4. Movements of gastric contents into esophagus
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8
Q

Events associated with vomiting x2

A
  1. Relaxation of diaphragm and upper esophageal sphincter
  2. Reversal of intrathoracic pressure from negative to positive
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9
Q

Describe effects of high and low tone of LES

A

High- leads to simple esophageal emptying > achalasia
Low- leads to reflux when gastric musculature contract

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10
Q

Multifactoral causes of rumination x4

A

Psychological
Behavioral
Involuntary
Dyspepsia (indigestion)

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11
Q

Vomiting centre is stimulated by x4

A

Chemoreceptor trigger zone
Vestibular system
Gastrointestinal
Cerebral cortex

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12
Q

Complications of vomiting x6

A

Metabolic alkalosis and electrolyte imbalance
Nutritional- malnutrition and failure to thrive
Mallory Weiss tear
Esophagitis
Aspiration
Shock

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13
Q

State location of thermoregulatory centers

A

Preoptic area of the anterior hypothalamus

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14
Q

Define malignant hyperthermia

A

A genetic disorder of the skeletal muscles that results in hypermetabolic response upon stimulation by volatile inhaled anesthetics or depolarizing muscle blockers

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15
Q

Infectious causes of fever x4

A

Malaria
Common cold
Gastroenteritis
Uncomplicated bacterial infections eg OM, pharyngitis, sinusitis

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15
Q

Inflammatory causes of fever x2

A

Vasculitis
Connective tissue disorder- IBD, SLE, RA

16
Q

Neoplastic causes of fever 2x2

A

Haematological: lymphoma, leukemia
Solid tumors: wilms, neuroblastoma

17
Q

Amber grading of fever characteristics x5

A

Wakes only with prolonged stimulation
Not responding normally to social cues
Nasal flaring
Crackles
RR >50bpm

18
Q

Red high risk grading of fever characteristics x5

A

Does not wake, if aroused does not stay awake
No response to social cues
RR > 60bpm
Chest indrawings
Grunting

19
Q

Investigations done on a febrile neonate x5

A

Blood culture
Urine culture
Stool culture
CSF culture
Chest radiograph

20
Q

Causes of Late onset neonatal bacterial diseases x4

A

E coli
Group B strep
L monocytogenes
Perinatally acquired HSV (give acyclovir)

21
Q

Serious bacterial infections in neonates x4

A

Meningitis, pneumonia, osteomyelitis, UTI

22
Q

Treatment of febrile infant x4

A

Benzylpenicillin, gentamycin, ceftriaxone
Acyclovir if HSV is suspected
IV empiric antibiotics

23
Q

Organisms causing serious bacterial disease in 1-3M infants x4

A

Hib, Ecoli
S aureus, L monocytogenes
S pneumonia, GBS

24
Q

Management of febrile infant < 3M x2

A

Parenteral antimicrobial therapy ceftriaxone or cefotaxime
Doubled ceftriaxone if meningitis is suspected

25
Q

Risk factors of occult bacteremia x3

A

Strep pneumonia
Temp > 39
WBC >15 000 cell/ mciroL

26
Q

Consequences of untreated occult bacteremia x3

A

Pneumococcal bacteremia > localized infection eg

27
Q

Bacterial infections with localizing signs x5

A

UTI, pneumonia, meningitis, osteomyelitis, sinusitis, OM

28
Q

Define cyclic vomiting

A

Idiopathic episodic ( >=2) attacks of intense nausea and paroxysmal vomiting lasting hours to days within a 6M period

29
Q

Cns causes of vomiting x4

A

Increased ICP
Abdominal epilepsy
Vestibular disorders
Ventriculoperitoneal shunt complications

PAEDIATRICS (20 decks)

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